[Nutritional epidemiology of coronary disease]

Abstract

The nutritional epidemiology of coronary disease is complex because nutrition is composed of a large number of factors which are susceptible to interfere with each other and to affect the coronary risk after a long period of exposure. The methodology of nutritional studies relies on known and validated enquiry techniques, but they are difficult to perform in the general population. The lipid nutritional hypothesis of coronary disease was centred on cholesterol and the saturated fatty acids. This lipid theory has allowed great advances in the pathophysiological and therapeutic areas. The concepts of a French paradox and global diet have allowed research in nutritional epidemiology to be refocused on other nutrients (lipids and non-lipids) and on alimentary fashions and lifestyle in general. The success of proposed diets at the population level depends strictly on correctly validated scientific data, and on the cultural and social context of where the prevention messages warrant dissemination.